三维斑点追踪技术评价正常成人左房功能的临床研究

Assessment of left atrial function in normal adults by three-dimensional speckle tracking imaging

目的探讨三维斑点追踪成像(3D-STI)技术评价正常成人左房功能的应用价值。方法选取健康志愿者104例,按年龄分为青年组(年龄18~44岁)、中年组(年龄45~59岁)及老年组(年龄≥60岁)。采集各组心脏全容积图像,应用3D-STI软件脱机分析获取左房容积曲线,比较各组左房最大容积指数(LAVImax)、左房最小容积指数(LAVImin)及左房收缩前容积指数(LAVIpre)、左房总排空容积指数(LAVIt)、总排空分数(LATEF)、扩张指数(EI)、被动排空容积指数(LAVIp)、被动排空分数(LAPEF)、主动排空容积指数(LAVIa)、主动排空分数(LAAEF)、被动排空容积占总排空容积比率(PE)及主动排空容积占总排空容积比率(AE)随年龄变化情况。结果 LAVImax、LAVIpre、LAVImin、LAVIt随年龄逐渐增大,三组比较差异有统计学意义(P<0.05);LATEF、EI三组比较差异无统计学意义;老年组LAVIp均较青、中年组增大;中、老年组LAPEF、PE均较青年组减低,差异均有统计学意义(均P<0.05);LAVIa、LAAEF随年龄增加而增大,三组比较差异有统计学意义(P<0.05);中、老年组均较青年组AE增大,差异均有统计学意义(均P<0.05)。结论 3DSTI技术可用于检测不同年龄段正常成人的左房容积及功能的变化规律,可为临床监测左房功能改变和发现亚临床心血管疾病提供一种可靠的辅助手段。

Objective To explore the application value of three-dimensional speckle tracking imaging（3D-STI）in evaluation of the left atrial function in normal adults. Methods A total of 104 volunteers were divided into adolescence（age18~44 years）,middle-aged（age 45~59 years）and elderly groups（age≥60 years）according to age. Full volume cardiac images were acquired and 3D-STI off-line analysis software was applied to get the time-volume curve of left atrium,the left atrial maximum volume index（LAVImax）,left atrial minimum volume index（LAVImin）,and left atrial pre-systole volume index（LAVIpre）were obtained,then the left atrial total emptying volume index（LAVIt）,left atrial total emptying fraction（LATEF）,left atrial expansion index（EI）,left atrial passive emptying volume index（LAVIp）,left atrial passive emptying fraction（LAPEF）,left atrial active emptying volume index（LAVIa）,left atrial active emptying fraction（LAAEF）,the passive emptying percentage of total emptying（PE）and the active emptying percentage of total emptying（AE）were calculated. Results LAVImax,LAVIpre,LAVImin and LAVIt increased with age in three groups,there were significant difference among three groups（all P〈0.05）,there were no significant difference in LATEF and EI among the three groups. LAVIp increased in elderly group when compared with the adolescence and middle-aged groups. Compared with adolescence group,LAPEF and PE decreased in the middle-aged and elderly groups,there were significant difference（all P〈0.05）. LAVIa and LAAEF increased with age in three groups,there were significant difference（P〈0.05）. Compared with adolescence group,the AE increased in middle-aged and elderly groups,there were significant difference（all P〈0. 05）. Conclusion Three-dimensional speckle tracking imaging can be used to detect changes of left atrial volume and function in normal adults of different age,providing a reliable means for monitoring the early changes of left atrial function and subclinical cardiovascular disease.